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February 7, 2023

Understanding Codependency

Bryan Duckham, Ph.D., MSW, LCSW

Related to addiction – the dependency on certain behaviors, substances, or materials – is another challenge termed “co-dependency,” a set of behaviors that was originally thought to arise from living with a person who had an addiction. As the understanding of the concept evolved, it became clear that co-dependency can occur as a result of many types of early family dysfunction. Because none of us come from perfect families, we all experience some features of co-dependency – it exists on a continuum. When it significantly impacts one’s sense of self, capacity to find meaning, and relationships, it must be addressed.

Generally, co-dependency can be defined as an excessive emotional or psychological reliance on a partner, typically one who requires support on account of an illness or addiction (Oxford Dictionary). As the understanding of the concept has broadened, it can more specifically be understood as a need to please or take care of others at one’s own expense. The accompanying behaviors include:

1) Difficulty with boundaries, such as saying no or setting limits with oneself or others

2) Difficulty expressing one’s thoughts and feelings

3) Feeling a need to take care of others’ needs at the expense of one’s own

4) A need to be liked at the expense of one’s true feelings or needs

5) Perfectionism, a fear of making mistakes and others’ disapproval

6) A need for control, especially over others

7) Reacting emotionally instead of accepting feelings and dealing with them in an optimal way for oneself and others

8) Fear of disapproval, anger, and abandonment

Often, these behaviors culminate in excess stress, anxiety and depression, relational problems, and a lack of purpose and meaning in life.

What happens in a person’s family of origin that may contribute to the development of co-dependency? The renowned pediatrician, Donald Winnicott, observed that when the needs of infants and toddlers were met, while also giving them the time and space to feel and imagine, a true self would emerge. Conversely, he and other child researchers noticed that neglect or impingements on the child led to a defensive coping style, the false self. Neglect and impingement can take the form of physical abandonment, lack of emotional attunement, intruding anxiety into the child, and various forms of abuse. Winnicott noted that the false self was hypervigilant in attunement to other’s feelings and needs as a way of defending against the failure they experienced.

Many who identify as co-dependent find 12-Step programs such as Co-Dependency Anonymous, Al-Anon, or Adult Children of Alcoholics. Because co-dependency behavior is a coping mechanism for early failure, much can be at stake for making these changes. Often, the co-dependent individual fears that saying no, expressing hurt or anger, and expressing wants or needs will lead others to get angry and reject them. These groups provide a unique function, including sharing with others who are struggling with the same issues, sponsorship with someone who has experienced greater healing, and working steps to change behavior, with the goal to help the individual eliminate or minimize co-dependency.

Individual therapy, with or without a 12-Step group, can be essential in overcoming co-dependency. One of the unique aspects of therapy is that it can create what Winnicott called a “holding environment.” This is where the therapist not only understands patterns of behavior and guides the client to insight, but also provides the conditions for them to express feelings and set boundaries without experiencing anger or rejection. This relational experience then gets translated for the client into their broader world. Those who commit to this process of recovery inevitably experience a connection with the true self, one that is more connected to feelings and needs. Because they are more connected to themselves, they also experience better connection with others. In addition, this connection to the true self often leads to a greater vision for their lives and a renewed, or newfound, sense of purpose.

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Bryan Duckham, Ph.D., MSW, LCSW

Bryan Duckham, Ph.D., MSW, LCSW has over 30 years’ experience in the treatment of depression, anxiety and addictions. In addition to private practice, Dr. Duckham has worked in a variety of outpatient mental health and addiction treatment programs. He believes that, often people’s religion and spirituality are essential parts of their recovery and sensitively integrates his clients’ beliefs into treatment.